The link between sleep behaviour and diabetes

Syarafina Radzi, 05 May 2017

A simple intervention, such as sleep extension, has been shown to have positive effects on insulin sensitivity.

The prevalence of diabetes has been linked to a number of factors, including genetics and several lifestyle factors. Experts have highlighted sleep behaviour as one of the lifestyle factors that can contribute to the onset and progression of diabetes.

Sleep imbalances may trigger diabetes

A review of the literature on sleep optimisation and diabetes control that was published in 2015 points to current evidence which suggests that sleep imbalance can potentially accelerate the onset of diabetes.

Conducted by Teresa Arora and Shahrad Taher, the study also proposes that sleep imbalance may also hinder glucose control and insulin sensitivity in patients with pre-existing diabetes.

Not sleeping at night may increase risk of diabetes

Another 2015 study which examined the difference between night and morning chronotypes (a person’s natural sleep-wake cycle) found that night owls are more likely to develop diabetes, metabolic syndrome and sarcopenia than early risers, despite their equal amount of sleep.

One of the study’s authors Nan Hee Kim of Korea University College of Medicine explained that this could be due to night owls’ tendency to have poorer sleep quality and engagement in unhealthy behaviours. These may include smoking, late-night eating and sedentary lifestyle.

Findings from a more recent study revealed that diabetics who were night owls reported more symptoms of depression compared to those who sleep and wake up early, regardless of their sleep quality.

Lead investigator Sirimon Reutrakul, an associate professor at Mahidol University Faculty of Medicine, said that the findings support an association between circadian regulation and psychological functioning in patients with Type 2 Diabetes.

Night shift workers have poorer glycaemic control

Reutrakul also led another study showing that people with Type 2 diabetes have poorer control over their blood glucose levels when working night shifts. The participants’ glycaemic control was determined by reviewing the recent measurements of haemoglobin A1C based on their medical records.

According to the results, night shift workers who participated in the study showed an average haemoglobin A1C level of 8.2%, compared to 7.6% A1C for daytime workers and 7.5% A1C for unemployed individuals.

In addition, night workers also tend to have shorter sleep duration, higher calorie consumption and higher body mass index (BMI) compared to the other two groups.

Duration of sleep influences diabetes progression

The relation between sleep duration and prevalence of diabetes was also investigated in another cross-sectional survey conducted among over 16,000 individuals aged 18 to 75 years old in Xuzhou, China, conducted by Rachel Leproult together with three other researchers.

Results from the 2015 study show that the prevalence of diabetes was higher in subjects who slept for six hours or fewer - 7.2% compared to 5.1% for those who slept for six to eight hours, and 6% for those who slept eight hours and more. This was independent of factors such as age, obesity, family history of diabetes, alcohol consumption, smoking behaviour, physical activity and other diseases.

All in all, the above findings demonstrate the necessity for enhanced public awareness on the importance of optimal sleep duration and healthy dietary habits. It is also crucial to educate individuals on how these factors relate to the risk and progression of diabetes.

A simple intervention, such as sleep extension, has been shown to have positive effects on insulin sensitivity. Thus, healthcare professionals need to be responsive to this in order to successfully manage diabetic patients, as well as the population with high risk of developing diabetes. MIMS